Clustering of lifestyle risk behaviours among residents of forty deprived neighbourhoods in London: lessons for targeting public health interventions

Background Clustering of lifestyle risk behaviours is very important in predicting premature mortality. Understanding the extent to which risk behaviours are clustered in deprived communities is vital to most effectively target public health interventions. Methods We examined co-occurrence and associations between risk behaviours (smoking, alcohol consumption, poor diet, low physical activity and high sedentary time) reported by adults living in deprived London neighbourhoods. Associations between sociodemographic characteristics and clustered risk behaviours were examined. Latent class analysis was used to identify underlying clustering of behaviours. Results Over 90% of respondents reported at least one risk behaviour. Reporting specific risk behaviours predicted reporting of further risk behaviours. Latent class analyses revealed four underlying classes. Membership of a maximal risk behaviour class was more likely for young, white males who were unable to work. Conclusions Compared with recent national level analysis, there was a weaker relationship between education and clustering of behaviours and a very high prevalence of clustering of risk behaviours in those unable to work. Young, white men who report difficulty managing on income were at high risk of reporting multiple risk behaviours. These groups may be an important target for interventions to reduce premature mortality caused by multiple risk behaviours.

Turning around the poorest neighbourhoods: learning the lessons from twenty years of neighbourhood-based regeneration strategies in England

In the past two decades governments in Britain have launched a series of initiatives designed to reduce the disparities between areas of affluence and deprivation. These initiatives were funded by central government and were delivered through a series of partnership boards operating at the neighbourhood level in areas with high levels of deprivation. Drawing on similar approaches in the US War on Poverty, the engagement of residents in the planning and delivery of projects was a major priority. This chapter draws on the national evaluations of three of these programmes in England: the Single Regeneration Budget, the New Deal for Communities and the Neighbourhood Management Pathfinders. The chapter begins by identifying the common characteristics of these programmes, known as area-based initiatives because they targeted areas of concentrated deprivation with a population of about 10,000 people each. It then goes on to discuss the three national programmes and summarises the main findings in relation to how far key indicators changed for the better. The final section sets out the ways in which policy objectives changed in 2010 after the election of a coalition government. This produced a shift to what was called the ‘Big Society’ where the rhetoric favoured a transfer of power away from central government towards the local, neighbourhood, level. This approach favoured self-help and a call to volunteering rather than channelling resources to the areas in greatest need. The chapter closes by reviewing the relatively modest achievements of this centralist, big-state approach to distressed neighbourhoods of 1990–2010.

Cultural value of architecture in homes and neighbourhoods

This paper provides an account of the Cultural Value of Architecture in Homes and Neighbourhoods, (CVoA), a project developed with the Royal Institute of British Architects (RIBA). The first stage of the project was a critical review of ‘grey literature’ since 2000, industry based research on the value of architecture subdivided into themes: overall value; health and wellbeing; neighbourhood cohesion and heritage and belonging. Findings from the review revealed a marked absence of evidence of the value of architecture and an over preoccupation with the final building, the product of an interdisciplinary team not just Architects, as well as a general confusion about what it is that Architects do. Further consultation has led to the development of a framework for defining and communicating the skillsets of Architects and for developing an evidence base for their value. Our target audience is non-Architects as we are concerned with making the profession more inclusive hence our desire to create simple definitions and terminology.

Social and environmental indexes to determine the impacts of closed neighbourhoods in Brazil

São Paulo State, in Brazil, is getting increasingly crowded, like in other third world countries around the world, so should give great importance to city development. This work considered the phenomenon of closed neighbourhoods (CN) as an important factor to city planning, papers report many impacts of this model of neighbourhoods in other countries, but in Brazil its impacts are not yet well listed in the literature. The aim of this work was to determine indicators to achieve the social and environmental performances and verify their applicability on three different closed neighbourhoods in São Paulo state, Brazil. The indicators were condensed on indexes: water management, waste management, energy and emissions, legal compliance, environment and buildings, risk management, health and education and governance. The preliminary results indicated several social and environmental problems in all indexes. © 2013 WIT Press.

Factors associated with overweight in children living in the neighbourhoods of an urban area of Brazil

Objective: The present study aimed to investigate the individual and family determinants of being overweight among children younger than 10 years of age. Design: Cross-sectional survey. Direct data on children's age, food intake, physical activity, type of transportation used and anthropometric measurements, as well as the education level of the mothers, were collected by trained interviewers. Setting: Population-based study in the city of Santos, Brazil. Subjects: A total of 531 children under 10 years of age (302 aged <6 years, >= 6 aged years), living in the city of Santos. Results: The overall prevalence of overweight and obesity (BMI-for-age Z-score >1) was 35.4% for children under 6 years and 38.9% for children aged 6-10 years. The socio-economic status of the family was associated with being overweight for both age groups. Logistic regression analysis showed that the lower the socio-economic status, the higher the likelihood of being overweight, among both younger children (OR = 7.73; P = 0.02) and older children (OR = 1.98; P = 0.04). The use of active transportation was associated with a lower likelihood of being overweight, but only among younger children (OR = 1.70; P = 0.05). Conclusions: Socio-economic status seems to be an important individual-level determinant of overweight in children. Public policies should consider promoting the use of active transportation, as the results showed it to have a positive effect on reducing overweight issues. The high prevalence of overweight in younger children suggests that this age group should be a priority in health-promoting interventions.

Gender-based violence and socioeconomic inequalities: Does living in more deprived neighbourhoods increase women's risk of intimate partner violence?

This study investigates the influence of neighbourhood socioeconomic conditions on women's likelihood of experiencing intimate partner violence (IPV) in Sao Paulo, Brazil. Data from 940 women who were interviewed as part of the WHO multi-country study on women's health and domestic violence against women, and census data for Sao Paulo City, were analyzed using multilevel regression techniques. A neighbourhood socioeconomic-level scale was created, and proxies for the socioeconomic positions of the couple were included. Other individual level variables included factors related to partner's behaviour and women's experiences and attitudes. Women's risk of IPV did not vary across neighbourhoods in Sao Paulo nor was it influenced by her individual socioeconomic characteristics. However, women in the middle range of the socioeconomic scale were significantly more likely to report having experienced violence by a partner. Partner behaviours such as excessive alcohol use, controlling behaviour and multiple sexual partnerships were important predictors of IPV. A women's likelihood of IPV also increased if either her mother had experienced IPV or if she used alcohol excessively. These findings suggest that although the characteristics of people living in deprived neighbourhoods may influence the probability that a woman will experience IPV, higher-order contextual dynamics do not seem to affect this risk. While poverty reduction will improve the lives of individuals in many ways, strategies to reduce IPV should prioritize shifting norms that reinforce certain negative male behaviours. (C) 2012 Elsevier Ltd. All rights reserved.